Introduction: Diagnostic point-of-care ultrasound (POCUS) is an important clinical skill in pediatric critical care. For patients to benefit from POCUS, clinicians must develop image acquisition and interpretation skills. Clinicians must also have the appropriate knowledge and confidence in these skills to implement them. We hypothesize that a simulated POCUS experience will effectively assess and improve trainees’ ultrasound skills, knowledge and confidence in implementation. Methods: In this prospective, simulation-based study, we enrolled pediatric critical care and emergency medicine fellows at a quaternary children’s hospital. They received review materials before the simulation to supplement their POCUS curricula. They completed a pre-simulation content test. Participants completed a focused cardiac and lung ultrasound skills assessment performed on a standardized patient (OSCE) which was evaluated by a POCUS expert. Next, participants went through a series of 2 simulated cases, shock and respiratory failure, with a standardized patient. Participants performed scans and received images based on the clinical context and made management decisions based on their interpretations. Following each scenario, participants received feedback. Afterwards, participants completed a survey. Results: We evaluated the performance of 15 pediatric fellows (9 CC, 6 EM). CC learners achieved mean scores of 18.1 ± 2.4 (Test), 78.2 ± 2.6 (Lung OSCE), and 53.3 ± 3.4 (Echo OSCE), while EM scored 16.0 ± 3.0, 63.0 ± 11.8, and 47.6 ± 10.5, respectively. Correlation analysis revealed strong associations between POCUS and OSCE performance (CC: r = 0.76 lung, r = 0.68 echo; EM: r = 0.99 echo). A post-training survey, using an 8-item Likert scale (1–5), assessed 3 key themes: overall value of experience, achievement of learning objectives, and fidelity of clinical scenarios. Mean scores ranged from 4.2 to 5.0 with strong internal consistency (Cronbach’s α = 0.79) reflecting high satisfaction and perceived effectiveness. Conclusions: We determined that a POCUS-based simulation improved pediatric critical care and emergency medicine trainees’ confidence in their POCUS skills and clinical integration abilities. Those with strong POCUS skills integrated POCUS more effectively into clinical care.
Burton et al. (Sun,) studied this question.